Healthcare Fraud

Updated

Jan 22, 2018

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To receive government funding, healthcare providers are required to file
claims which catalog payment information, as well as submit specific
records to support their claims. If healthcare providers submit claims
or records that are falsified or intentionally misleading in an effort to
procure unwarranted federal funds, they may be in violation of the False
Claims Act.

Healthcare fraud is the most damaging form of government fraud,
accounting for more than $60 billion lost taxpayer dollars each year.
Despite this substantial figure, the government has no watchdog group in
place to contain healthcare fraud and thus relies almost entirely on
False Claims Act whistleblowers to recover stolen funds.

Common Forms of Healthcare Fraud

Listed below are the most common ways in which companies and individuals
defraud Medicare and Medicaid annually.

Billing for services or supplies never provided

Filing misleading cost reports

Submitting falsified records

Offering kickbacks or other illegal bribes

Marketing drugs or medical devices for non-approved purposes

Why Does Healthcare Fraud Occur?

One of the reasons the federal government is unable to adequately
recognize healthcare fraud is because the falsified payment information
is hidden underneath medical jargon. Often, healthcare companies will
make it seem like certain services were performed or necessary (when, in
actuality, neither one nor the other is true) by using medical terms
which, to anyone without a medical degree, would seem legitimate. For
this reason, whistleblowers in healthcare fraud cases are typically
employees of the fraudulent company who are familiar with medical
procedures and company practices.

In such cases, it is not unusual for the whistleblower to become
concerned about job security and workplace harassment for filing a False
Claims Act lawsuit. Fortunately, the law protects whistleblowers from
employer retaliation and discrimination of any kind, even offering
compensation in the event harassment takes place.

At Morgan and Morgan,
not only can we help you file a claim safely and securely, but we can
ensure that, as a whistleblower, you are protected to the full extent of
the law. To learn more about the False Claims Act and whistleblower
protection, simply fill out our free case
evaluation to have an attorney review your
claim, at no cost to you.